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Revenue

12 Months Ended

Dec. 31, 2022

Revenue.

Revenue

Note 14.  Revenue

We derive our revenue from the sale and rental of our products to our customers in the United States. The following table presents our revenue, inclusive of sales and rental revenue, disaggregated by product:

​

​	​	​	​	​	​	​	​	​
​	Year Ended
​	December 31,
(In thousands)	2022		​	2021		​	2020
Revenue	​	​	​	​	​	​	​	​
Lymphedema products	$	212,266	​	$	202,913	​	$	187,130
Airway clearance products	​	34,519	​	​	5,144	​	​	—
Total	$	246,785	​	$	208,057	​	$	187,130
​	​	​	​	​	​	​	​	​
Percentage of total revenue	​	​	​	​	​	​	​	​
Lymphedema products		86%	​		98%	​		100%
Airway clearance products	​	14%	​	​	2%	​	​	N.M.
Total		100%	​		100%	​		100%

​

Our revenue by channel, inclusive of sales and rental revenue, for the years ended December 31, 2022, 2021 and 2020 are summarized in the following table:

​

​	​	​	​	​	​	​	​	​
​	Year Ended
​	December 31,
(In thousands)	2022		​	2021		​	2020
Private insurers and other payers	$	139,087	​	$	141,377	​	$	132,789
Veterans Administration	​	25,507	​	​	25,654	​	​	24,485
Medicare	​	47,672	​	​	35,882	​	​	29,856
Durable medical equipment distributors	​	34,519	​	​	5,144	​	​	—
Total	$	246,785	​	$	208,057	​	$	187,130

​

Our rental revenue is derived from rent-to-purchase arrangements that typically range from three to ten months. As title transfers to the patient, with whom we have the contract, upon the termination of the lease term and because collectability is probable, under ASC 842, these are recognized as sales-type leases. Each rental agreement contains two components, the controller and related garments, both of which are interdependent and recognized as one lease component.

The revenue and associated cost of revenue of sales-type leases are recognized on the lease commencement date and a net investment in leases is recorded on the Consolidated Balance Sheet. We bill the patients’ insurance payers monthly over the duration of the rental term. We record the net investment in leases and recognize revenue upon commencement of the lease in the amount of the expected consideration to be received through the monthly payments. Similar to our sales revenue, the transaction price is impacted by multiple factors, including the terms and conditions contracted by various third party payers. As the rental contract resides with the patients, we have elected the portfolio approach, at the payer level, to determine the expected consideration, which considers the impact of early terminations. While the contract is with the patient, in certain circumstances, the third party payer elects an initial rental period with an option to extend. We assess the likelihood of extending the lease at the onset of the lease to determine if the option is reasonably certain to be exercised. As the lease is short-term in nature, we anticipate collection of substantially all of the net investment within the first year of the lease agreement. Completion of these payments represents the fair market value of the equipment, and as such, interest income is not applicable.

​

Rental revenue for the years ended December 31, 2022, 2021 and 2020, was primarily related to private insurers. Sales-type lease revenue and the associated cost of revenue for the years ended December 31, 2022, 2021 and 2020, was:

​

​	​	​	​	​	​	​	​	​	​	​
​	​	​	Year Ended December 31,
(In thousands)	​	​	2022		​	2021		​	2020
Sales-type lease revenue	​	​	$	35,440	​	$	30,143	​	$	25,633
Cost of sales-type lease revenue	​	​		11,190	​		9,622	​		9,011
Gross profit	​	​	$	24,250	​	$	20,521	​	$	16,622

​

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- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI https://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
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-URI https://asc.fasb.org/extlink&oid=126920106&loc=SL49130551-203045

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